Final 2019 open enrollment report: ACA sign-ups dip to 11.4M

CMS issued its final Health Insurance Exchanges 2019 Open Enrollment Report on March 25, touting stabilized premiums and extended “grandmother” policies amid sign-ups that numbered 300,000 fewer than last year.

After a 23 percent average premium increase in 2017 and an additional 31 percent increase in 2018, average monthly premiums for plans purchased through HealthCare.gov for 2019 were down $9, from $621 in the previous open enrollment period (OEP) to $612. After tax credits were applied, the average premium for this year was $87—$2 less than last year’s OEP.

Plan selections in exchange plans in all states and D.C. dipped slightly, as well, averaging around 11.4 million and down 300,000 from last year. The decline was significant but not nearly as detrimental as the Congressional Budget Office’s 2017 prediction that sign-ups would be down by 3 million in 2019.

CMS Administrator Seema Verma remained positive, taking to Twitter to report “another successful enrollment period at a time when premiums are stabilizing after years of substantial increases.”

According to a CMS statement, the decrease in plan selections can likely be attributed to a lower demand for exchange coverage, since more employers are sponsoring insurance for employees who no longer need subsidized health coverage through the government. Additionally, 100,000 individuals enrolled in the exchange in Virginia at the end of 2018 reported incomes that would make them eligible for Medicaid expansion this year.

CMS also announced it would be extending its policy on “grandmothered plans”—health plans that took effect after the ACA was signed into law in 2010 but before the exchanges opened in October 2013. Verma said the one-year extension should help enrollees with those plans continue to afford health insurance they wouldn’t otherwise be able to.

“Not extending the grandmothered plan policy would cancel plans that are meeting people’s needs today and, as a result, force people to decide between buying coverage they cannot afford on the individual market or going uninsured,” she said in the statement. “By extending the grandmothered plan policy, we are following through on our commitment to protect those left behind by Obamacare.”

Find the full OEP Final Report here.